宫腔镜辅助下分段诊刮术与单纯分段诊刮术诊断子宫内膜癌的比较

为比较宫腔镜辅助下分段诊刮术与单纯分段诊刮术在诊断子宫内膜癌中的临床意义 ,将经手术后病理证实的子宫内膜癌患者分为 2组 :宫腔镜辅助下分段诊刮组 (A组 ) 3 1例 ;单纯分段诊刮组 (B组 ) 3 9例。比较 2组术前诊断子宫内膜癌的准确性及开腹手术时腹水细胞学的检查结果。 2组患者的年龄、临床病理分期、病理分级及组织学类型差异无显著性。A组诊断宫颈受累的准确率为 96.77% (3 0 / 3 1 ) ,假阳性率为 3 .2 3 % (1 / 3 1 ) ;B组分别为 79.49%(3 1 / 3 9) ,1 5 .3 8% (6/ 3 9)。 2组准确率比较 ,差异有显著性 (P <0 .0 5 )。取腹水或腹腔冲洗液行细胞学检查。A组细胞学阳性率为 6.45 % (2 / 3 1 ) ,B组为 1 4.2 9% (3 / 2 1 ) ,2组间差异无显著性 (P >0 .0 5 )。提示 :宫腔镜辅助下分段诊刮术可提高术前诊断子宫内膜癌的准确性 ,从而避免不必要地扩大手术范围 ,而且不增加腹腔内播散的危险。     

572例近视眼患者中央角膜厚度测量报告

本文作者在572例(1144只眼)近视眼患者拟行角膜放射状切开(RK)手术前,对角膜不同部位厚度进行了测量,对其值作统计学处理,均值及标准差为0.527±0.037mm,标准误为0.002,说明我国95％的近视眼患者中央角膜厚度范围为0.455—0.600mm。提示我国成人各年龄组左、右眼角膜厚度与左、右眼屈光度、性别、眼别无关。强调RK手术前对角膜厚度测量的重要性,但手术预后优劣为多因素所致。     

B超测量皮脂厚度的临床应用

目的 :采用B型超声诊断仪进行皮脂厚度测量 ,探讨B超与皮皱厚度卡尺测定结果的相关性。　方法 :选取健康成人 2 19例 ,非疾病死亡 10h之内尸体 11例。用B型超声诊断仪和皮皱厚度卡尺分别测量皮脂厚度。　结果 :B超与皮皱厚度卡尺测量值比较 ,二者差异不显著 (P >0 .0 5 )。　结论 :B型超声诊断仪用于临床评价皮脂厚度是可行的     

高血压患者左室舒张功能与左室肥厚的关系及随龄改变

为探讨原发性高血压 (以下简称高血压 )患者的左室舒张功能和左室肥厚的关系及其随龄改变 ,抽取 1995年 2月至 2 0 0 2年 7月间门诊高血压患者 4 81例为高血压组 ,以同期体检健康者 2 54 3例为对照组 ,年龄 10～ 80岁 ,并将原发性高血压患者分为 3级 ,每级中按性别分 2组。采用惠普 2 50 0彩色多普勒超声诊断系统检测 2组的室间隔厚度、左室后壁厚度、E/A等指标。使用SPSS软件进行统计学处理分析。结果 :高血压和正常对照组相比E/A显著下降 ,室间隔和左室后壁显著增厚 (P <0 .0 1)。 2个组的E/A均随年龄下降 ,而室间隔厚度随年龄增厚 ,且室间隔厚度和E/A呈显著负偏相关 (P <0 .0 1)。在高血压分级组中 ,Ⅰ～Ⅲ级高血压组中男性的室间隔厚度均厚于女性 (均P <0 .0 1) ,Ⅰ、Ⅱ级高血压组中男性的左室后壁厚度厚于女性 (P <0 .0 5,P <0 .0 1) ,Ⅰ级高血压组中女性的E/A低于男性 (P <0 .0 5)。提示 :左室舒张功能随着年龄的增加而降低 ,而且和高血压左室肥厚呈负偏相关关系 ,性别对其也有一定的影响     

Effect of age, breast size, menopausal and hormonal status on mammographic skin thickness

Background/purpose: The localized or generalized skin thickness detected on mammography may reflect an underlying pathology of breast or a systemic disease involving the skin. The aim of this report is to describe the range of normal breast skin thickness in women using a film-screen mammographic technique.
Methods: Measurement of the mammographic skin thickness over different parts of the breast was performed in 144 women who had normal findings in a combined mammographic and ultrasonographic examination. Patients were grouped as premenopause, postmenopause and surgical menopause who were under continuous oestrogen treatment. The skin thickness in four regions (superior, inferior, medial, lateral) of both breasts was compared, and their relations with age, breast size, menopausal and hormonal status were investigated. The interobserver reliability was tested in a small subgroup of patients.
Results: Interobserver agreement was good for all measurements. The range of normal breast skin thickness was between 0.50 and 3.10 mm. There were no differences in skin thickness between the corresponding regions of the breasts, with significant differences between the regions in the same breast. While breast size increased with age, skin thickness decreased in all regions.
Conclusion: The breast size, age, regional variations and hormonal status of the patients should be considered when defining the normal range of skin thickness in mammographic examinations. We assume that upper limit of mammographic skin thickness should be set as 3.0 mm, regardless of the focal spot size and film-focus distance.     

Current treatment options for abnormal uterine bleeding: an evidence-based approach

Heavy menstrual bleeding is the predominant complaint in women with abnormal uterine bleeding. Treatment options are drug therapy, and first- and second-generation endometrial resection. Many women will subsequently have a hysterectomy. Uterine fibroids are the most common solid pelvic tumours in women, and although many fibroids seem to cause no symptoms, they can have serious adverse effects and impact on quality of life. As women postpone having children, gynaecologists will have to manage fibroids and polyps in a conservative manner. The past decade has witnessed the development of highly sophisticated diagnostic and therapeutic technology for women suffering from menorrhagia, fibroids and polyps, including minimally invasive uterine therapy. The tools currently at our disposal permit greater management flexibility, which must be tailored to the individual clinical situation. This chapter reviews the evidence-based approach and minimally invasive therapy.     

经阴道超声诊断子宫内膜癌

目的 探讨应用经阴道超声（TVS）诊断绝经前后出血妇女子宫内膜癌的价值。方法 采用彩色多普勒超声诊断仪检测74例阴道异常出血的妇女，其中绝经前28例，绝经后46例，所有患者均取子宫内膜组织行病理对照。结果 TVS检测子宫内膜癌的敏感性、特异性、假阳性率、假阴性率、阳性预测值和阴性预测值，绝经前妇女依次为61．5％，50．0％，14．3％，23．8％，94．1％和54．5％，绝经后妇女依次为97．3％，55．6％，44．4％，2．7％，90．0％和83．0％。结论 TVS检测可作为子宫内膜癌首选的筛查方法，尤其对于绝经后妇女价值更大。     

Isolation and characterization of endometrial leukocyte populations by flow cytometry

Potentialities of the flow cytornetry method in studies of the qualitative and quantitative composition of endometrial immunocompetent cells are demonstrated. The studied leukocyte populations are found to occur in negligible quantities in the endometrium. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 117, N ^o 1, pp. 68–71, January, 1994.     

胰岛素样生长因子-1受体在子宫内膜癌中的表达及临床意义

目的 研究子宫内膜癌组织中IGF-1R的分布、表达及其临床意义。方法 选取30例子宫内膜癌手术标本，石蜡切片，采用PV-600PicTureTM检测试剂进行免疫组化，测定IGF-1R的分布及表达，分析与临床病理之间的关系。另取10例正常的增生期子宫内膜标本作为对照。结果 IGF-1R为膜受体。IGF-1R在10例正常增生期子宫内膜细胞中的阳性表达率为70％，无过度表达；而在30例子宫内膜癌细胞中的阳性表达率为90％，过度表达率为40％（中度阳性7例、强阳性5例）。统计表明，正常增生期子宫内膜细胞与子宫内膜癌细胞相比IGF-1R阳性表达率差异尤显著性（P=0．13）；IGF-1R过度表达率差异有显著性（P=0．017）。子宫内膜癌细胞膜IGF-1R阳性表达及过度表达在高分化与中、低分化之间有显著差异（与分级呈负相关系：分化越低，IGF-1R的表达越强，反之，分化高，IGF-1R的表达则弱）。IGF-1R的阳性表达及过度表达在临床分期Ⅰ-Ⅲ期各组间均无明显差异。结论 IGF-1R在子宫内膜癌细胞膜表达，且随恶性程度的增加其表达量增加，IGF-1R的表达量可以预测内膜癌的预后，对临床治疗可能具有一定的指导意义。     

小剂量阿斯匹林辅助促排卵过程中对子宫血流及内膜厚度的影响

目的　探讨小剂量阿斯匹林在促排卵过程中对子宫血流及内膜厚度的影响及其作用机理。方法　采用前瞻性随机双盲的方法 ,对不明原因的不孕妇女在克罗米酚 (CC)促排卵治疗同时 ,自月经第 1～ 2 0d连续服用小剂量阿斯匹林 ,75mg/d。 结果　试验组子宫动脉血流阻力指数 (RI)明显低于对照组 (P <0 0 1) ,子宫内膜厚度明显较对照组厚 (P <0 0 5 )。结论　小剂量阿斯匹林可增加子宫血流供应 ,从而改善促排卵治疗时CC所致的子宫内膜发育不良